Organization
SLC VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY W DUSTIN RN, MSN (CASE MANAGER)
(801) 582-1565
Entity
Organization
Contact information
Practice address
500 FOOTHILL DRIVE, SALT LAKE CITY, UT 84148
(801) 582-1565
Mailing address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
184759-3102
UT
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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